A Pune-based cardiologist has carried out transcatheter aortic valve replacement (TAVR) procedure upon an 87-year-old man and a 78-year-old woman who got their damaged heart valves replaced with prosthetic valves without undergoing surgery. Claimed to be a first for the city, the procedure was carried out at the Poona Hospital and Research Centre.

In both cases, an artificial heart valve was guided all the way to the heart through a femoral artery by making a small puncture in the groin as is done in the cardiac stent procedure.

The whole procedure was done under local anaesthesia. The patients were slightly sedated though conscious throughout the procedure, fully acting upon the doctor’s commands in between.

The game-changing procedure has been done in Pune twelve months after a cardiologist from abroad had demonstrated it at a city hospital.

Dr Suhas Hardas, the cardiologist at the Poona Hospital and Research Centre who carried out the advanced procedure on the patients, said, “Both the patients are doing well. Breathlessness, palpitation and chest pain, with which they were living for the last five to six years, have now resolved. Barring a small dose of blood thinner, they are off most symptomatic medications.”

Dr Hardas told that the 87-year-old man, a businessman from Baramati, had undergone the TAVR procedure on March 22. “He had undergone open heart surgery in the past. A repeat open heart surgery to fix the aortic valve was not safe in his case. Besides, his bones have become brittle and fragile. He also has kidney problem,” he added.

The cardiologist also told that the man, for the past five years, had been suffering from critical aortic stenosis and that his heart’s blood pumping rate had reduced considerably and the ejection fraction was 35%.

One of the relatives of this patient told that the man had been pulling off with the help of diuretics and blood pressure medicines along with blood thinning drugs. The patient was kept under observation in the hospital’s ICU for 24 hours following the procedure and was discharged on March 25.

“Poor heart functioning had restricted my grandfather’s physical activity. He had also become very negative. He has started feeling more active and positive just within a week of undergoing the procedure. He has already started doing most of his physical activities again,” the man’s grandson said.

The other person who received the prosthetic valve was a 78-year-old woman from Khadki. Dr Hardas told, “The woman was diagnosed with critical aortic stenosis six years ago and has been suffering from asthma for the past six years with both the lungs badly affected. She had been pulling off with the aid of drugs. She underwent the TAVR procedure on March 22 and was discharged from hospital on March 26.”

The procedure is, however, expensive and not affordable for many patients. Dr Hardas said, “Cost is the major deterrent. The procedure costs between Rs 25 lakh and Rs 30 lakh with an imported valve. The cost may reduce by lakhs of rupees if an India-made valve is used.” He added, “The procedure is causing a paradigm shift towards providing less invasive and safer cardiac procedures which are not only scar-free but are well endured even by elderly patients.